1.Development of Computerized Surveillance Programs based on a Hospital Electronic Medical Records System.
Ja Hyun KANG ; Hong Bin KIM ; Ho Jun CHIN ; Kyoung Un PARK ; Eun Hwa CHOI
Korean Journal of Nosocomial Infection Control 2004;9(2):107-116
BACKGROUND: As information technology evolves rapidly computer-based surveillance systems for nosocomial infection have been developed. Well designed computerized system could provide an opportunity for improving, enlarging, and conducting hospital-wide surveillance more efficiently in the situation with limited resources. Recently, we launched a new computerized monitoring system in a hospital where digital medical information system has been operated without paper chart. METHODS: We developed a new surveillance program based on the total Electronic Medical Record (EMR) system. Numerous critical medical information can be easily accessible through this system without further work. This includes major demographic data, essential information from the inpatient medical record, the laboratory information system, and the pharmacy information, Comprehensive Clinical Data Repository (CDR) system was also developed. CDR is potentially very useful to conduct a hospital-wide surveillance by integrating all the available information. RESULTS: This system consists of several programs in the EMR and the CDR environment. In the EMR system, inquiry for patients with fever, case ascertainment and registration of nosocomial infections, inquiry for patients with indwelling devices, microbiological reports, and data on antibiotic prescriptions were included. The CDR has integrated comprehensive inquiries for frequency of major pathogens in clinical isolates and their trends of antibiotic resistance, nosocomial infection rates based on the duration of the devices or hospitalization, and the history of antimicrobial usage based on defined daily dosage. Data obtained from the EMR and the CDR systems could be easily accessed by infectious diseases specialists and healthcare workers of infection control services at any place within the hospital. A new reporting system has been built up to facilitate identification of notifiable diseases among the list of diagnoses on the EMR. In addition, the "Alert" notice was designed to highlight isolation precautions for indicated cases. CONCLUSION: This new computerized surveillance program might be a valuable model to which other hospitals can refer to develop newer version of programs in the future.
Clinical Laboratory Information Systems
;
Communicable Diseases
;
Cross Infection
;
Delivery of Health Care
;
Diagnosis
;
Drug Resistance, Microbial
;
Electronic Health Records*
;
Fever
;
Hospitalization
;
Humans
;
Infection Control
;
Information Systems
;
Inpatients
;
Medical Records
;
Pharmacy
;
Prescriptions
;
Specialization
2.A Case of Mesoblastic Nephroma of Kidney in Adult.
Ja Hwan KOO ; Ho Jun AN ; Chang Kyu LEE ; Hyun Yul RHEW
Korean Journal of Urology 1999;40(11):1566-1568
Mesoblastic nephroma or fetal mesenchymal hamartoma of the kidney is an uncommon congenital tumor of infancy that rarely occurs in adults. This tumor is slow growing tumor considered to originate from renal mesenchyme and is separated this relatively benign lesion from its malignant counterpart, malignant nephroblastoma(Wilms` tumor). We report a case of mesoblastic nephroma incidentally detected left renal mass and treated with radical nephrectomy in 50 years old man.
Adult*
;
Hamartoma
;
Humans
;
Kidney*
;
Mesoderm
;
Middle Aged
;
Nephrectomy
;
Nephroma, Mesoblastic*
3.Sex Differences in Lifestyle Factors of Metabolic Syndrome in Korean Adults.
Jun Seok SON ; Byung Mann CHO ; Young Wook KIM ; Chang Ho CHAE ; Chan Woo KIM ; Ja Hyeon KIM
Korean Journal of Health Promotion 2012;12(1):13-21
BACKGROUND: Metabolic syndrome is a major risk factor for cardiovascular disease. The combination of an aging population with a chronic diseased population is leading to an increase in the mortality rate due to cardiovascular diseases. The purpose of this study was to assess the prevalence of metabolic syndrome in the Korean population and to evaluate its related factors for sex differences. METHODS: From April 2007 to December 2008, a total of 2,729 volunteers aged 40-69 years living in Changwon city underwent a clinical examination at a hospital in Changwon, Korea. Metabolic syndrome was diagnosed following the criteria defined in Circulation 2009. The clinical examination included measuring anthropometric variables and cardiovascular risk factors, while lifestyle factors were assessed through a questionnaire. RESULTS: The prevalence of metabolic syndrome in our sampling pool was 25.2% with a break down by sex showing a rate of 30.2% in men and 22.2% in women. Related factors associated with metabolic syndrome common to both sex were age, self-health assessment, and alcohol consumption. Sleep duration seemed to be a related factor in men, while income, education, and menstruation status played significant roles in women. CONCLUSIONS: To better manage metabolic syndrome, men need to be educated on alcohol use and women of low socioeconomic status require particular attention as do the aging population and postmenopausal women.
Adult
;
Aged
;
Aging
;
Alcohol Drinking
;
Cardiovascular Diseases
;
Female
;
Humans
;
Korea
;
Life Style
;
Male
;
Menstruation
;
Prevalence
;
Risk Factors
;
Sex Characteristics
;
Social Class
4.A Case of Percutaneous Intracavitary Amphotericin B Injection for the Treatment of Hemoptysis due to Pulmonary Aspergilloma.
Woa Ja LIM ; Kook Kyu KIM ; Myung Jun KIM ; Jong Gil WOO ; Hong Suk KIM ; Byung Ho KIM
Tuberculosis and Respiratory Diseases 1994;41(1):42-46
Pulmonary Aspergillomas usually arise from proliferation of Aspergillus in preexisting parenchymal cavities.202 college students (99 men, 103 women) aged 18% 26 years. Fasting blood samples were. The most common symptom in this disorder is hemoptysis, which may be minimal in amount or it may be massive & life threatening. The optimum therapy for pulmonary aspergilloma is controversial. The major options available include surgical resection of the lesion, a number of medical therapies, or simple observation of the patient for a time. Surgery is the most effective treatment but it is limited to some patient because most patients haute underlying pulmonary disease. Thus the various form of medical therapy was available with successful result. The authors present a case of percutaneous intracavitary amphoterician B injection for the treatment of pulmonary aspergilloma & its successful effect for the repetitive hemoptysis.
Amphotericin B*
;
Aspergillus
;
Fasting
;
Hemoptysis*
;
Humans
;
Lung Diseases
;
Male
5.Geographic Distribution of Central Nervous System Rehabilitation Treatment in Korea and Its Associated Factors
Dong-Gyun SOHN ; Jaehong YOON ; Jun-Soo RO ; Ja-Ho LEIGH
Journal of Korean Medical Science 2023;38(20):e147-
Background:
Health disparity is defined as a difference in the accessibility of medical resources among regions or other factors. In South Korea, there might be a disparity because of the low proportion of public medical institutions. This study aimed to investigate the geographic distribution of rehabilitation treatment and examine the factors associated with the rates of rehabilitation treatment in Korea.
Methods:
We used administrative claims data in 2007, 2012, and 2017 from the National Health Insurance Database in Korea. We defined physical therapy and occupational therapy as rehabilitation treatments and analyzed the rate of rehabilitation treatments for administrative districts in 2007, 2012, and 2017. Interdecile range and coefficient of variation were used to investigate the geographic distribution of rehabilitation treatment over time. We applied multiple random intercept negative binomial regression to examine the factors associated with rehabilitation treatment. A total of 28,319,614 inpatient and outpatient claims were submitted for 874 hospitals that provided rehabilitation treatment in 2007, 2012, and 2017.
Results:
The increase in the mean rates of physical therapy inpatients and outpatients was greater than those for occupational therapy inpatients and outpatients from 2007 to 2017. Both physical therapy and occupational therapy were concentrated in the Seoul Capital Area and other large urban areas. More than 30% of the districts received no rehabilitation treatment. The interdecile range and coefficient of variation for physical therapy declined more than those for occupational therapy from 2007 to 2017. The deprivation index was negatively correlated with physical therapy inpatients, physical therapy outpatients, occupational therapy inpatients, and occupational therapy outpatients. Furthermore, a 1-unit increase in the number of hospital beds per 1,000 people was associated with 1.42 times higher physical therapy inpatient, 1.44 times higher physical therapy outpatient, 2.14 times higher occupational therapy inpatient, and 3.30 times higher occupational therapy outpatient treatment.
Conclusion
To reduce the geographic inequality in rehabilitation treatment, it is necessary to narrow the gap between the supply and demand of rehabilitation services. Providing incentives or direct provisions from the government might be an alternative.
6.Spinal Arachnoid Cyst: Treated with Pars Osteotomy and Recapping Laminoplasty: Report of 5 Cases.
Weon Wook PARK ; Seong Jun AHN ; Ja Gyung KU ; Moo Ho SONG ; Seong Ho YOO ; Suk Woong KANG
Journal of Korean Society of Spine Surgery 2009;16(3):215-221
Spinal arachnoid cysts are a rare disease with an unknown origin. Because of their broad base, a total laminectomy with or without fusion has been the treatment of the choice. We encountered 5 patients with a spinal arachnoid cyst who were treated by recapping laminoplasty after pars osteotomy. This procedure has not been reported in Korea. All patients showed neurological recovery with no recurrence of the cyst. The findings on the stressed plain film confirmed bony union and stability of the posterior element.
Arachnoid
;
Arachnoid Cysts
;
Humans
;
Korea
;
Laminectomy
;
Osteotomy
;
Rare Diseases
;
Recurrence
7.A case of Smith-Lemli-Opitz syndrome confirmed by molecular analysis: Review of mutation spectrum of the DHCR7 gene in Korea.
Moon Yeon OH ; Jun Suk KIM ; Ja Hye KIM ; Ja Hyang CHO ; Beom Hee LEE ; Gu Hwan KIM ; Jin Ho CHOI ; Han Wook YOO
Journal of Genetic Medicine 2014;11(2):86-90
Smith-Lemli-Opitz syndrome (SLOS) is a rare autosomal recessive disorder caused by 7-dehydrocholesterol reductase deficiency. The characteristic clinical features are syndactyly of the second and third toes, facial dysmorphism, multiple malformations, and intellectual disability. Few cases of SLOS have been reported in Korea. We observed a male patient with SLOS who presented with typical facial features, undescended testes, microcephaly, bilateral syndactyly of the second and third toes, and cardiac defects, including patent ductus arteriosus and atrial septal defect. Mutation analysis of the DHCR7 gene identified compound heterozygous mutations of c.907G>A (p.Gly303Arg) and c.1055G>A (p.Arg352Gln). In a review of the literature, c.1054C>T (p.Arg352Trp) was the most common mutation reported in Far East Asian countries. This report describes the clinical features, biochemical data, molecular characteristics, and clinical outcome of a Korean patient with SLOS.
Asian Continental Ancestry Group
;
Cryptorchidism
;
Ductus Arteriosus, Patent
;
Far East
;
Heart Septal Defects, Atrial
;
Humans
;
Intellectual Disability
;
Korea
;
Male
;
Microcephaly
;
Smith-Lemli-Opitz Syndrome*
;
Syndactyly
;
Toes
8.Lipid Composition of Serum HDL and Fatty Acid Composition of Serum Cholesteryl Esters in Newborn.
Jung Hee KIM ; Dong Wook KIM ; Dae Deok AHN ; Jung Kwon LEE ; Yoon Ja KIM ; Jun Chull KIM ; Tai Ho CHUNG
Journal of the Korean Pediatric Society 1985;28(12):1190-1195
No abstract available.
Cholesterol Esters*
;
Humans
;
Infant, Newborn*
9.Uranyl Nitrate Induced Polyuric Acute Tubular Necrosis in Rats.
In Kyoung LIM ; Kee Ho LEE ; Byung Don HAN ; Ja Jun JANG ; Taik Koo YUN
Yonsei Medical Journal 1987;28(1):38-48
We investigated the pathobiological course of uranyl nitrate (UN) induced polyuric acute tubular necrosis (ATN) in male Sprague Dawley rats. UN (5mg/kg 15mg/kg and 3Omg/kg) in 5% NaHCO3 induced weight loss, polydipsia, and polyuria 24 hrs after injection when compared to the controls which were treated with 5% NaHCO3 only. Twenty four hours following the injection of UN, serum creatinine and blood urea nitrogen levels had increased. These changes continued for at least 72 hours, although the concentration of uranium had decreased. Light microscopic studies conducted 24 hours after injection, revealed partial degeneration and necrosis of the proximal tubules and many casts m the distal convoluted tubules. These changes progressed for 72 hours. Despite this tubular damage, the glomeruli were relatively intact. 5 days after injection, the epithelial cells lining the proximal tubules displayed regenerative activities; these findings were more prominent after 10 days. Through electron microscopic examination, we observed the destruction of mitochondria in the proximal tubular cells, a possible cause of polyuria. Ten days post injection regenerative activities in the proximal tubular cells showed that the maturation of intracellular organelles followed the proliferation of the premature cells.
Animal
;
Kidney Failure, Acute/chemically induced*
;
Kidney Function Tests
;
Kidney Tubular Necrosis, Acute/chemically induced*
;
Male
;
Rats
;
Rats, Inbred Strains
;
Uranium/pharmacology*
;
Uranyl Nitrate/pharmacology*
10.Control of Refractory Ascites by Dialytic Ultrafiltration in Patients with Advanced Liver Cirrhosis.
Sang Jin HAN ; Eui Hun JEONG ; Gwang Ho BAIK ; Dong Seok YOON ; Myung Bin KIM ; Moon Soo KOH ; Ja Ryong KOO ; Ung Ki JANG ; Dong Jun KIM
Korean Journal of Medicine 1997;53(5):628-635
BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Abdomen
;
Aldosterone
;
Anti-Bacterial Agents
;
Ascites*
;
Ascitic Fluid
;
Blood Pressure
;
Blood Urea Nitrogen
;
Carcinoma, Hepatocellular
;
Chemistry
;
Creatinine
;
Drainage
;
Electrolytes
;
Filtration
;
Fluid Therapy
;
Heart Rate
;
Humans
;
Hypotension
;
Korea
;
Liver Cirrhosis*
;
Liver*
;
Paracentesis
;
Patient Rights
;
Peritonitis
;
Plasma
;
Punctures
;
Renin
;
Ultrafiltration*